The U.S. is moving toward universal influenza vaccination of children (UIV-C). The goal of this project is to evaluate the feasibility of implementing UIV-C within primary care offices. This project will investigate, throughout New York State (NYS), primary care provider perceptions of UIV-C, factors that affect influenza vaccination in both positive and negative directions, new practice-based strategies that would be needed for UIV-C, and resources (costs) needed for successful UIV-C. This study has three components: [unreadable] [unreadable] SURVEY: We will conduct a mailed survey of primary care pediatricians and family physicians across NYS (final n=1,200), stratified by geography, physician type, and practice type. Measures will include: perceptions of UIV-C, barriers, facilitating factors, and strategies currently used (e.g., "flu vaccination clinics"). This study will identify new office policies, strategies and resources needed for UIV-C, and will compare strategies and resources according to physician or practice characteristics. [unreadable] [unreadable] RESOURCE UTILIZATION STUDY: We will perform a detailed study of a stratified sample of 30 practices, selected from survey participants, to measure all direct and indirect resources consumed for influenza vaccinations. For each practice, we will obtain (a) an office manager survey of personnel and non-personnel resources utilized, (b) a self-administered time-flow study of vaccination visits, and (c) a direct observation study to measure time and resources utilized. We will compare resources/costs by physician and practice characteristics and measure the costs of special influenza vaccination strategies. [unreadable] [unreadable] MODELING: We will develop a model for the resources and costs needed for practice-based UIV-C for various age groups and physician or practice characteristics. We will extrapolate this model to forecast for the U.S. by comparing the statewide findings with national data from national datasets. [unreadable] [unreadable] DISSEMINATE FINDINGS: We will use multiple modalities in collaboration with professional organizations (e.g., AAP, AAFP, APA) and public health leaders. Findings will inform policy-makers about practice-based costs of UIV-C and will guide health care providers about best-practice models of UIV-C. [unreadable] [unreadable] This experienced, multidisciplinary research team will adapt methods they have used successfully for 15 years to study childhood immunizations, health care financing, and policy to the new challenge of UIV-C. [unreadable] [unreadable] [unreadable]